L7 - MSK Upper Extremity Osteology Flashcards
What 2 bones make up the Shoulder Girdle?
- Clavicle 2. Scapula
What are the 3 parts of the Clavicle?
- Sternal End 2. Body/Shaft 3. Acromial End
What does the Clavicle articulate with?
The Manubrium of the Sternum and the Acromion of the Scapula
What are the features of the Sternal End of the Clavicle? What do they articulate with?
Sternal End: Possesses Articular surface for Manubrium 1. Sternal Facet –> articulate with Manubrium at Clavicular Notch 2. Impression for the Costoclavicular L. –> small depression on inferior surface –> attachment to Costoclavicular L. to the 1st Rib
Where is the Subclavian Groove location and what does it do?
On the Body/Shaft of Clavicle - Inferior surface - Attachment point for Conoid L.
What are the 3 features of the Acromial End of the Clavicle?
- Acromial Facet 2. Conoid Tubercle 3. Trapezoid Line
What does the Acromial Facet of the Acromial End of the Clavicle do?
Articulates with an Articular facet on the Acromion of Scapula
What is the attachment point for the Conoid L. on the Clavicle?
Conoid Tubercle Inferior Surface of Acromial End of Clavicle
What attaches to the Trapezoid Line on the Clavicle? Where is it on clavicle?
Trapezoid L. Inferior Surface or Acromial End of Clavicle
What is one of the most fractured bones due to direct and indirect injuries received by falling? What are they referred to in younger children when incomplete?
The Clavicle “Greenstick” Fracture: since often incomplete
What is the triangular, flat bone, that rests on the posterior Thoracic Wall? Capable of movement at which joint?
Scapula Scapulothoracic Joint
Scapula borders?
4/7
6
9/11
Lateral (Axillary): 4 & 7
Medial (Vertbral): 6
Superior: 9&11
- Suprascapular Notch
- Coracoid Process
What is transmitted by the Suprascapular Notch?
Suprascapular A. and N.
Located on Superior Border of Scapula
What is the Coracoid Process and what does it do?
- Anteriorly bent process of scapula
- provides attachment for muscles and ligaments
What is the articular surface for the Humeral Head on the Scapula called?
Glenoid Cavity of Scapular Head
What is the attachment point for the Long Head of the Biceps Brachii M.?
Supraglenoid Tubercle
- superior to Glenoid Cavity on Scapular Head
What is the attachment point for the Long Head of the Triceps Brachii M.?
Infraglenoid Tubercle
- Triangular Bump
- Inferior to Glenoid Cavity of Scapular Head
What is the slight constriction between the Scapular Head and Lateral Border?
Scapular Neck
Where is the Superior Angle of Scapula located?
btwn the Superior and Medial Borders
Where is the inferior angle of the scapula located?
between the Medial and Lateral Borders
Where is the Lateral angle of the scapula located?
between the Superior and Lateral Borders
What is the boney ridge that stretches transversely across the Posterior Surface from the Medial Border to the Lateral Angle ending at the Acromion?
Scapular Spine
What is the point of the shoulder called?
- Acromion
- possesses an articular surface for the clavicle
What is the convex surface of the Scapula?
Posterior Surface
What features are on the Posterior Surface of the Scapula? (4)
- Scapular Spine - Acromion - Deltoid Tubercle 2. Greater Scapular Notch 3. Supraspinous Fossa 4. Infraspinous Fossa
What attaches to the Deltoid Tubercle?
Deltoid M.
What is the short passage between the Lateral Border and the Lateral Attachment point of the Scapular Spine to the Posterior Surface?
Greater Scapular Notch
What is the location of the Supraspinatus M.?
Supraspinous Fossa
What is located at the Infraspinous Fossa?
Infraspinatus M.
What is the smooth and concave side of Scapula?
Costal (Anterior) Surface
What is located at the Subscapular Fossa?
Subscapularis M.
What does the Humerus articulate with?
Articulates: - Proximally with Glenoid Cavity of Scapula - Distally with Ulna and Radius Bones
What is at the Proximal End of the Humerus?
Humeral Head - rounded, smooth surface - articulate with Glenoid Cavity of Scapula
What is between the Humeral Head and Humeral Tubercles?
Anatomical Neck of Humerus
What is between the Proximal End of the Humerus and Shaft? Is is a common fracture site?
Surgical Neck It is a Common fracture site - hence name
Most common fracture site of Humerus? Common avulsion?
CN: The most common fracture site on the Humerus is at the Surgical Neck. The Greater Tubercle is also susceptible to avulsion by the Supraspinatus, Infraspinatus and Teres minor Ms. that insert there.
What is located on the lateral border of the Humerus? What attaches there?
Greater Humeral Tubercle Attachment point for: - Supraspinatus - Infraspinatus - Teres Minor M.
What projects anteriorly from the Humerus? What attaches there?
Lesser Humeral Tubercle Attachment Point for: - Subscapularis M.
What is the Intertubercular Groove? What attaches there?
- located between Humeral Tubercles - transmits the Long Head of the Biceps Brachii T. - Attachment point for: - Pectorial Major - Teres Major - Latissimus Dorsi
What is the Deltoid Tuberosity and what inserts there?
Located on Body of Humerus Insertion point for Deltoid M.
What is the Groove for Radial N. and what transmits here?
Located on Body of Humerus Transmits the: - Radial N. - Deep Brachial A.
What is the Medial Supracondylar Ridge?
Located on Distal End of Humerus - transition point between Body and the widened Distal End
What is the Lateral Supracondylar Ridge?
Located on Distal End of Humerus
- Above Humeral Condyle (“Epi” = upon)
- transition point between Body and the widened Distal End
What is the Lateral Humeral Epicondyle?
Located on Distal End of Humerus
- Above Humeral Condyle (“Epi” = upon)
- common origin for several Antebrachial Extensors
What is the Medial Humeral Epicondyle?
Located on Distal End of Humerus
- common origin for several Antebrachial Flexors
- Groove for Ulnar N. on it
What transmits the Ulnar N. on the Humerus?
Groove for Ulnar N. on Distal End of Humerus on Medial Humeral Epicondyle
What is the origin of the expression “funny bone”?
CN: The Groove for the Ulnar N. houses the Ulnar N. and when compressed is painful. This is the origin of the expression “funny-bone” relating to the presence of the Ulnar N. in this groove on the Humerus (humorous = funny).
What can severe ABduction of the extended elbow cause?
CN: Severe abduction of the extended elbow, an abnormal movement at this joint, can result in Avulsion of the Medial humeral Epicondyle.
Where is the Humeral Condyle located? What does it host?
Located on Distal end of Humerus
- Arrangement of articular surfaces and depressions for the articulation with the Ulna and Radius Bones
Capitulum and Trochlea present
What articulates with the Trochlear Notch of the Proximal Ulna?
Trochlea Articular Surface of the Humeral Condyle on the Distal End of Humerus
What is the smooth, rounded process, on the Humeral Condyle (Distal End of Humerus)? What does it articulate with?
Capitulum Articulates with concave Radial Head
What are the Anterior Depressions of the Humeral Condyle on Distal End of Humerus?
Radial Fossa Coronoid Fossa
What are the Articular Surfaces of the Humeral Condyle on Distal End of Humerus?
Trochlea Capitulum
What does the Radial Fossa do? Where is it located?
Accommodates the Radial Head when Antebrachium is Flexed An Anterior Depression Located on Distal End of Humerus at Humeral Condyle
What does the Coronoid Fossa do? Location?
Accommodates Coronoid Process of the Ulna when the Antebrachium is Flexed. Anterior Depression on Humeral Condyle of Distal End of Humerus
What is the Olecranon Fossa?
Posterior Depression on Humeral Condyle of Distal End of Humerus - Accommodates the Olecranon of the Ulna when Antebrachium is Extended
What is the CN of a “Fractured Elbow”?
CN: Fracture of the Olecranon, often referred to as “Fractured Elbow” is common in cases of falling, because of the forceful nature of the Triceps Brachii M. this is considered an avulsion fracture and is difficult to repair.
What is medial of the two Antebrachial Bones? What articulates here?
Ulna Articulates: Proximally: with Humerus and Radius Distally: with Radius
Is the Proximal or Distal End of the Ulna larger?
The Proximal End is larger
What is the point of the elbow? What bone is it located on?
Olecranon Proximal End of Ulna - Provides level for extension of the Antebrachium
What is the hook shaped part on the Proximal end of the Ulna called?
Radial Notch
What surface of what bone?
1-8?
Inferior Surface of Clavicle
- Acromial Facet
- Conoid Tubercle
- Trapezoid Line
- Subclavian Groove
- Impression for the Costoclavicular L.
- Sternal Facet
- Acromial End
- Sternal End
- Acromion
- Coracoid Process
- Greater Scapular Notch
- Scapular Spine
- Deltoid Tubercle
- Infraspinous Fossa
- Supraspinous Fossa
Angles and Borders of Scapula
- (Anterior) Costal Surface
- Posterior Surface
- Lateral Angle
- Lateral (Axillary) Border
- Inferior Angle
- Medial (Vertebral) Border
- Lateral (Axillary) Border
- Lateral Angle
- Superior Border
- Superior Angle
- Superior Border
1-5
- Olecranon
- Radial Notch
- CoroNoid Process
- Ulnar Tuberosity
- Ulnar Head
6-8
- Trochlear Notch
- Radial Notch
- Ulnar Styloid Process
1-4
- Olecranon
- CoroNoid Process
- Radial Notch
- Ulnar Tuberosity
5-8
- Trochlear Notch
- CoroNoid Process (same as 2)
- Radial Notch (same as 3)
- Supinator Crest
1.
4.
5.
6.
- Fovea of the Radial Head
- Radial Head
- Radial Neck
- Radial Tuberosity
2.
3.
7.
8.
9.
- Articular Surface for Carpal Bones
- Dorsal Tubercle
- Ulnar Notch
- Articular Surface for Carpal Bones (same as 2)
- Radial Styloid Process
What is a Colle’s Fracture?
CN: Fractures of the Distal End of the Radius (from breaking falls) are common and are referred to as Colle’s fracture. The Styloid Process of the Ulna is often also avulsed in this situation.
Dinner Fork Deformity
What view point?
1-8
Carpals, Posterior Aspect (Back of Hand)
- Scaphoid (skyscaper)
- Lunate (crescent moon)
- Triquetrum (Triangle)
- Pisiform (Pea shape)
- Hamate (Hambone)
- Capitate (Largest, Head)
- Trapezoid (Pointer finger)
- Trapezium (Thumb)
So Long To Pinky Here Comes The Thumb
What is the most commonly fractured Carpal Bone?
What is clinically significant about it?
Is is often misdiagnosed?
Scaphoid
CN: The Scaphoid is the most commonly fractured Carpal Bone, and is usually the result of trying to break a fall, often the fracture in not visible on a radiograph and therefore misdiagnosed as a severe sprain. The distal fragment of bone is susceptible to avascular necrosis since it is usually separated from its blood supply.
What carpal bones articulate with Radius?
Scaphoid
Lunate
Triquetrum - kind of - since it articulates with Articular Disc of Radiocarpal Joint (more with Ulna than Radius)
What is Carpal Tunnel Syndrome?
What nerve is affected?
What part of hand affected?
What is the treatment?
CN: The passage anterior to the Carpal Bones posterior to the Flexor Retinaculum is known as the Carpal Tunnel and transmits the tendons of the Flexor Digitorum Profundus and Superficialis Ms. as well as the Flexor Carpi Radialis T. and Median N.
If swelling of the tendons occurs the Median N. can be compressed resulting in Carpal Tunnel Syndrome, which produces parasthesia, anesthesia and pain.
*Numbness and Pain = Thumb to mid 4th Digit (Ring Finger)**
*Treatment: Cut Transverse Carpal Ligament
What is Guyon’s Canal Syndrome?
What Nerve is affected?
What part of hand is affected?
CN: The depression between the Pisiform and Hamulus of the Hamate is known as the Ulnar Canal (Guyon Tunnel) and the Ulnar N. passes through this canal and is susceptible to compression, which manifests as loss of sensation and muscular weakness.
* Ring finger to Pinky area numb and weak
What aspect of carpals?
1-11?
Anterior Aspect of Carpals
- Scaphoid
- Scaphoid Tubercle
- Tubercle of the Trapezium
- Trapezium
- Trapezoid
- Capitate
- Hamulus of the Hamate
- Hamate
- Pisiform
- Triquetrium
- Lunate
What is a Boxer’s Fracture?
CN: The Head of the 5th Metacarpal is susceptible to fracture when an individual punches something with a closed fist, this condition is sometimes referred to as “Boxer’s Fracture.”
The end of the 5th metacarpals takes the force of impact and breaks at its neck and angulates towards the palm creating a dorsal bump.
What are these called?
Metacarpals 1-5
What are these called?
Proximal Phalanges 1-5
What are these called?
Intermediate Phalanges 1-4
**Only 4, starting at pointer finger
*Not on thumb
What are these called?
Distal Phalanges 1-5
*on every digit
What are these areas called?
Are they present on each metacarpal and phalange?
- Head
- Body
- Base
Yes, present on each metacarpal and phalange.
What is a common result of closing fingers in doors?
What is the clinical significance?
CN: Fractures of the Distal Phalanges are commonly the result of fingers being closed in a door, because of the intricate relationship between Phalanges and flexor tendons bone fragments must be realigned carefully to maintain function.
What Joint is this? (A)
1-4?
A. Sternoclavicular Joint
- Intact Sternoclavicular Joint
- Articular Disc
- Manubrium
- Clavicle
What joint is this? (A)
1-3?
A. Acromioclavicular Joint
- Clavicle
- Articular Disc
- Acromion
A. What type of Joint?
- ?
A. Glenohumeral Joint
- Glenoid Labrum
When do Glenoid Labrum Tears typically occur?
CN: The Glenoid Labrum commonly tears in individuals repeatedly throwing a ball, usually in response to a sudden contraction of the Biceps Brachii M. and occurs in the anterosuperior part of the Labrum.
What Joint is this?
1-6?
Is Ulna part of this joint?
Radiocarpal Joint
- Radius
- Ulna
- Articular Disc
- Scafoid
- Lunate
- Triquetrum
Ulna not really a part of joint since articular disc blocks it from contact with carpals
